Reported occupational respiratory diseases in Catalonia

Abstract

Objectives: A voluntary surveillance system was implemented in Catalonia (Spain) to ascertain the feasibility, incidence, and characteristics of occupational respiratory diseases and compare them with those of the compulsory official system. Methods: In 2002, in collaboration with the Occupational and Thoracic Societies of Catalonia, occupational and chest physicians and other specialists were invited to report, on a bimonthly basis, newly diagnosed cases of occupational respiratory diseases. Information requested on each case included diagnosis, age, sex, place of residence, occupation, suspected agent, and physician's opinion on the likelihood that the condition was work related. Compulsory official system data derived from statistics on work related diseases for possible disability benefits declared by insurance companies, which are responsible for declaring these diseases to the Autonomous Government of Catalonia. Results: Of 142 physicians seeing patients with occupational respiratory diseases approached, 102 (74%) participated. Three hundred and fifty nine cases were reported, of which asthma (48.5%), asbestos related diseases (14.5%), and acute inhalations (12.8%) were the most common. Physicians rated 63% of suspected cases as highly likely, 28% as likely, and 8% as low likelihood. The most frequent suspected agents reported for asthma were isocyanates (15.5%), persulphates (12.1%), and cleaning products (8.6%). Mesothelioma (5.9%) was the most frequent diagnosis among asbestos related diseases. The number of acute inhalations reported was high, with metal industries (26%), cleaning services (22%), and chemical industries (13%) being the most frequently involved. The frequency of occupational respiratory diseases recorded by this voluntary surveillance system was four times higher than that reported by the compulsory official system. Conclusions: The compulsory scheme for reporting occupational lung diseases is seriously underreporting in Catalonia. A surveillance programme based on voluntary reporting by physicians may provide better understanding of the incidence and characteristics of these diseases. Persulphates and cleaning products, besides isocyanates, were the most reported causes of occupational asthma. Metal industries and cleaning services were the occupations most frequently involved in acute inhalations with a remarkably high incidence in our register.

Prevention of Occupational Asthma

“…Occupational asthma (OA) has been reported to be the most common chronic occupational disease in many developed countries [1,2], and as with other occupational lung diseases, it is potentially preventable. It refers to de novo asthma or recurrence of previously quiescent asthma (ie, asthma as a child or in the distant past that has been in remission) induced by sensitization to a specific substance (eg, an inhaled protein [high molecular weight] or a chemical at work [low molecular weight], termed sensitizer-induced OA) or by exposure to an inhaled irritant at work, termed irritant-induced OA [3].…”

Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*

“…The most common occupational agents inducing rhinitis and asthma. In most countries, the same occupational agents are the most common causes of asthma and rhinitis (566,(567)(568)(569). These include: isocyanates (570), flour and grain, wood dust (135,571,572), glutaraldehyde and anhydrides (573), solder/colophony (574-576), laboratory animals, insects (577), resins and glues (578), latex (137), metal salts (141) and persulfates (579,580).…”

Prevalencia de asma relacionada con el trabajo y su impacto en atención primaria de salud

“…Además, la prevalencia media de asma exacerbado en el trabajo entre los adultos con asma se estima en el 21% 6 . Teniendo en cuenta que el asma afecta al 5-10% de la población adulta europea (en España se estima un 5%) 16,17 , el ART representa un grave problema de salud pública, con importantes implicaciones socioeconómicas 13,18,19 Un problema importante de la salud laboral en nuestro país está en que el AO, en muchas ocasiones, no es detectada y diagnosticada como tal en los servicios especializados del sistema sanitario laboral, los servicios de prevención de las empresas y las Mutuas de Accidentes de Trabajo y Enfermedades Profesionales de la Seguridad Social (MATEPSS), sino que es diagnosticada y tratada como contingencia común en la red de atención primaria (AP) 20,21 . Ello conlleva un retraso o un no diagnóstico de ART, que ocasiona un grave perjuicio para los trabajadores afectados ya que, como continúan expuestos al agente causal, evolucionan hacia el empeoramiento, la cronicidad y la pérdida de capacidad de trabajo, y también para el resto de trabajadores con exposiciones y tareas similares, ya que la empresa no adopta medidas preventivas y no se evitan nuevos casos.…”